Candidemia outcomes not improved with statin use.

Candidemia is an important cause of morbidity and mortality. As statins interfere with yeast membrane synthesis, we assessed whether use of statins during candidemia may cause differences in clinical outcomes. A retrospective review of 124 candidemia episodes during 2003-2008 in which all-cause and attributable mortality, length of stay and level of care were compared for patients who received and those who did not receive statins. A total of 124 candidemia events were observed involving 14 patients on statins and 110 without statins. Overall mortality in candidemia cases was 46%, but only 2% was attributed to candidemia. No differences were observed in clinical outcomes for the two groups of patients. During the last 2-year period of our study, there were higher rates of candidemia caused by non-C. albicans Candida spp., particularly those due to C. glabrata and C. parapsilosis. In conclusion, statin use during candidemia did not alter mortality, length of stay, or intensive care requirement of our patients, despite higher rates of non-C. albicans Candida species isolated during the last 2 years of our study.

Greater HIV testing after Veterans Health Administration policy change: the experience from a VA Medical Center in a high HIV prevalence area.

Veterans Health Administration changed its HIV testing policy to remove requirements for written informed consent with pretest/posttest counseling and to make testing part of routine care in August 2009. HIV testing percentages were compared for 1-year periods before and after this change at our medical center located in Washington, DC, the city with the highest US HIV prevalence. After this policy change, HIV screening rose from 5.5% to 10.3% of persons in care with the majority of testing in outpatient settings and the greatest increase among veterans aged 61-70. Broadening of HIV testing has significance for HIV detection and prevention.